Efficacy of triple DMARD therapy in patients with RA with suboptimal response to methotrexate

James Robert O'Dell, Claire Haire, Nils Erikson, Walter Drymalski, William Palmer, Pierre Maloley, Lynell Warren Klassen, Steven Wees, Gerald Francis Moore

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46 Citations (Scopus)

Abstract

Rheumatoid arthritis (RA) has a profound effect on patients, producing significant morbidity and in some cases mortality. Because of this, most rheumatologists are moving to disease modifying antirheumatic drug (DMARD) therapy earlier in the course of RA. Methotrexate (MTX) has become the initial DMARD of choice for most rheumatologists. Unfortunately, treatment of RA with a single DMARD, including MTX, often results in a suboptimal response. Therefore, most rheumatologists are now using combinations of DMARD to treat patients with RA who have had incomplete responses to single DMARD therapy. The Rheumatoid Arthritis Investigational Network (RAIN) reported the results of a double blind, controlled comparison of triple drug therapy (MTX-sulfasalazine-hydroxychloroquine) against MTX alone, and against the combination of hydroxychloroquine and sulfasalazine. Twenty-eight patients who had suboptimal responses to MTX or the combination of sulfasalazine and hydroxychloroquine were then treated with triple therapy in an open label study. Fourteen had previously failed MTX therapy, and 14 had previously failed combination therapy with sulfasalazine and hydroxychloroquine. Both groups had statistically significant improvements in sedimentation rates, morning stiffness, swollen joint scores, tender joint scores, patient global status assessment, and physician global status assessment. Statistical significance was reached for all these variables for patients in both groups, but improvement was greater for the patients in the sulfasalazine-hydroxychloroquine group. Patients with RA who have had suboptimal responses to MTX, or to the combination of sulfasalazine-hydroxychloroquine, show both statistical and clinically significant improvement in multiple clinical variables when treated with the combination of MTX 17.5 mg/week, sulfasalazine 500 mg bid, and hydroxychloroquine 200 mg bid.

Original languageEnglish (US)
Pages (from-to)72-74
Number of pages3
JournalJournal of Rheumatology
Volume23
Issue numberSUPPL. 44
StatePublished - Mar 1 1996

Fingerprint

Antirheumatic Agents
Hydroxychloroquine
Sulfasalazine
Methotrexate
Rheumatoid Arthritis
Drug Therapy
Joints
Therapeutics
Morbidity
Physicians
Mortality

Keywords

  • Combination therapy Methotrexate
  • DMARD
  • Hydroxychloroquine
  • Rheumatoid arthritis
  • Sulfasalazine

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

O'Dell, J. R., Haire, C., Erikson, N., Drymalski, W., Palmer, W., Maloley, P., ... Moore, G. F. (1996). Efficacy of triple DMARD therapy in patients with RA with suboptimal response to methotrexate. Journal of Rheumatology, 23(SUPPL. 44), 72-74.

Efficacy of triple DMARD therapy in patients with RA with suboptimal response to methotrexate. / O'Dell, James Robert; Haire, Claire; Erikson, Nils; Drymalski, Walter; Palmer, William; Maloley, Pierre; Klassen, Lynell Warren; Wees, Steven; Moore, Gerald Francis.

In: Journal of Rheumatology, Vol. 23, No. SUPPL. 44, 01.03.1996, p. 72-74.

Research output: Contribution to journalArticle

O'Dell, JR, Haire, C, Erikson, N, Drymalski, W, Palmer, W, Maloley, P, Klassen, LW, Wees, S & Moore, GF 1996, 'Efficacy of triple DMARD therapy in patients with RA with suboptimal response to methotrexate', Journal of Rheumatology, vol. 23, no. SUPPL. 44, pp. 72-74.
O'Dell JR, Haire C, Erikson N, Drymalski W, Palmer W, Maloley P et al. Efficacy of triple DMARD therapy in patients with RA with suboptimal response to methotrexate. Journal of Rheumatology. 1996 Mar 1;23(SUPPL. 44):72-74.
O'Dell, James Robert ; Haire, Claire ; Erikson, Nils ; Drymalski, Walter ; Palmer, William ; Maloley, Pierre ; Klassen, Lynell Warren ; Wees, Steven ; Moore, Gerald Francis. / Efficacy of triple DMARD therapy in patients with RA with suboptimal response to methotrexate. In: Journal of Rheumatology. 1996 ; Vol. 23, No. SUPPL. 44. pp. 72-74.
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